Application Form

This application is only possible for Mosa students having received their personal student number.

School year *

Hosting request for *

French intensive course in August

Week-ends and holidays during the school year

Mosa student number *

First Name *

Last Name *

Email *

Student spoken language(s), other than native

May you child can travel alone, on foot or by public transport to the French course? *

Yes

Do you agree that your child sleeps in the same bedroom as another child (same gender)? *

Yes

Has your child a special diet? *

Yes

Student diet details

Has your child an allergy? *

Yes

Allergy details

Is your child receiving medical treatment? *

Yes

Is your child afraid of pets (dog, cat, etc.)? *

Yes

Feared pets details

Indicate here any information that you consider useful for us to organize your child's stay

Job

Department

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